MATTERHORN Trial: Promising Results and Unanswered Questions
Key Points
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The MATTERHORN trial showed positive outcomes with perioperative durvalumab added to the standard of care in gastric and gastroesophageal junction cancer.
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Questions remain about how to implement these findings into clinical practice, specifically for esophageal cancers.
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For patients who face disease progression or recurrence shortly after intensified frontline therapy, optimal treatment regimens remain uncertain.
At the 2025 American Society of Clinical Oncology (ASCO) Annual Meeting, Supriya Peshin, MD, of Ballad Health, spoke with Deepak Vadehra, DO, of Roswell Park Comprehensive Cancer Center, about the latest data from the MATTERHORN trial.
The phase 3 study evaluated the addition of perioperative durvalumab to standard of care perioperative FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) in gastric and gastroesophageal junction cancers. Preliminary findings indicated significant improvements in event-free survival and pathologic complete response (pCR) rates with the durvalumab combination.
While Dr. Vadehra was optimistic that the final data update from MATTERHORN will be positive, he questioned whether an increased pCR rate will translate into an overall survival benefit.
Another outstanding question is whether the MATTERHORN trial data are relevant to esophageal adenocarcinomas where FLOT is also the standard of care.
The sequencing of therapies also is a critical issue. It’s unclear if patients who receive immunotherapy in earlier lines of therapy and have disease progression will have benefit with reusing the same chemotherapy agents or immunotherapies later on.
Despite these unanswered questions, Dr. Vadehra said, there is a lot of warranted excitement for positive results with new treatments and combinations, given that gastric cancer is a very aggressive cancer with a poor prognosis.